Administrative Costs at Minnesota Health Plans in 2008
June, 2010
Health Economics Program PO Box 64882 St. Paul, MN 55164-0882 http://www.health.state.mn.us/healtheconomics
Introduction The Minnesota Department of Health is required to collect and publish information on
administrative costs of health plans (group purchasers) that do business in Minnesota.1 This
report presents data on 2008 administrative costs for all health plans that reported more than $3
million in total health premiums for Minnesota residents.
The detailed tables on the following pages present information on administrative costs as
reported by group purchasers for each of 14 categories of administrative spending. Appendix A
provides the definitions of the 14 administrative cost categories included in this report.
Averaged across all health plan companies, the following table shows administrative costs as a
share of total costs over time:
Year
2001
2002
2003
2004
2005
2006
2007
2008
Administrative Cost as %
of Total Cost
10.6%
8.9%
8.3%
8.6%
8.3%
8.3%
8.4%2
8.1%
As required by Minnesota Statutes Section 62J.321, subdivision 5, health plans were provided an
opportunity to review and comment on the data included in this report. MDH received no
comments from health plans.
Comments or questions related to this report may be directed to Tom Major at (651) 201-3574 or
by email to [email protected] .
1
Minnesota Statutes, Section 62J.38, paragraph (b). Revised from 8.2% to 8.4% since initial publication in January 2009 due to changes in data reported by health
plans.
2
Table 1. Administrative Costs as Percent of Total Costs, 2008
Total 2008
Administrative
Costs
2008 Health Plan Companies
American Family Mutual Insurance Company
Ameritas Life Insurance Corp
Bankers Life and Casualty Company
Blue Cross Blue Shield of Minnesota
Blue Plus
Combined Insurance Company of America
Companion Life Insurance Company
Connecticut General Life Insurance Company
Delta Dental Plan of Minnesota
Federated Mutual Insurance Company
First Health Life & Health Insurance Company
FirstSolutions
Great-West Life & Annuity Insurance Company
Guarantee Trust Life Insurance Company
Guardian Life Insurance Company of America
HCC Life Insurance Company
HealthPartners
Humana Insurance Company
HumanaDental Insurance Company
Itasca Medical Care
John Alden Life Insurance Company
Lincoln National Life Insurance Company
Medica Health Plans
Medica Insurance Company
Medica Self Insured
Metropolitan HealthPlan (MHP)
Metropolitan Life Insurance Company
Mutual of Omaha Insurance Company
Pan-American Life
Pennsylvania Life Insurance Company
Physicians Mutual Ins. Co. & Physicians Life Ins. Co.
PreferredOne Community Health Plan
PreferredOne Insurance Company
PrimeWest Health System
Principal Life Insurance Company
Pyramid Life Insurance Company
ReliaStar Life Insurance Company
RxAmerica, LLC
Security Life Insurance Company of America
SilverScript Insurance Company
South Country Health Alliance
State Farm Mutual Automobile Insurance Company
Sterling Life Insurance Company
Sun Life Assurance Company of Canada
Time Insurance Company
UCare Minnesota
UniCare Life & Health Insurance Company
Union Security Insurance Company
United HealthCare Insurance Company
United World Life Insurance Company
WellCare Prescription Insurance, Inc.
World Insurance Company
Totals:
Total 2008
Spending
3,542,802
12,238,319
447,019
3,079,661
1,682,019
10,785,041
377,713,620
4,229,992,076
66,308,681
973,671,179
1,012,019
5,144,365
147,891
1,674,011
24,994,611
317,857,830
51,435,715
872,810,335
8,473,189
72,633,366
902,679
14,749,933
6,569,938
111,741,371
1,207,362
15,352,288
4,190,528
18,866,662
733,475
16,288,793
950,226
13,348,338
216,990,823
2,994,203,871
38,657,455
313,904,806
912,597
2,556,376
3,654,199
37,835,147
1,008,861
5,382,319
219,176
4,943,805
64,811,247
1,005,393,368
139,104,669
1,269,775,290
62,708,306
1,317,407,043
32,089,152
162,539,540
5,316,919
60,322,041
1,405,949
10,344,978
49,924
3,375,218
2,723,242
20,301,814
1,486,745
6,963,123
17,404,417
154,342,295
2,162,674
15,374,591
19,456,228
129,824,930
3,259,217
59,006,750
1,118,150
9,881,963
2,285,994
23,205,273
567,856
6,649,393
712,825
3,689,496
381,906
8,307,761
17,477,564
183,625,668
3,346,875
22,409,503
564,254
4,086,596
503,772
3,261,663
10,270,863
42,736,069
68,692,520
1,142,386,175
19,426,232
173,682,101
3,387,270
22,017,694
23,013,806
377,615,326
1,808,001
7,192,756
998,262
8,486,158
1,803,060
10,271,073
1,320,092,784 16,313,535,541
2008
Administrative
Costs (as a
percent of total
spending)
28.95%
14.52%
15.60%
8.93%
6.81%
19.67%
8.83%
7.86%
5.89%
11.67%
6.12%
5.88%
7.86%
22.21%
4.50%
7.12%
7.25%
12.32%
35.70%
9.66%
18.74%
4.43%
6.45%
10.96%
4.76%
19.74%
8.81%
13.59%
1.48%
13.41%
21.35%
11.28%
14.07%
14.99%
5.52%
11.32%
9.85%
8.54%
19.32%
4.60%
9.52%
14.94%
13.81%
15.45%
24.03%
6.01%
11.18%
15.38%
6.09%
25.14%
11.76%
17.55%
8.1%
Minnesota Health Plan Spending on Administrative Services, 2008
Total Administrative Spending as percent of Total Carrier Spending: 1
8.1%
Commercial Administrative Spending as percent of Commercial Spending:
9.5%
MN Public Programs Administrative Spending as percent of MN Public Programs Spending:
7.3%
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare Advantage, Part D, and
Medicare Supplement):
11.4%
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total Carrier Spending;
thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare categories.
Indirect Health Care Expenses (Medical and Dental), 2008
Indirect Expense Category
Salaries and
Benefits
Other Expense
Total Indirect
Health Care
Expense
(by category)
Percent of
Total Admin
Expenses
Percent of
Total
Expenses
Billing and Enrollment
31,788,183
59,054,349
90,842,532
6.9%
0.6%
Claim Processing
88,578,964
140,769,962
229,348,926
17.4%
1.4%
2,090,424
1,874,174
3,964,598
0.3%
0.0%
Customer Service
52,459,719
41,592,871
94,052,590
7.1%
0.6%
Product Management and Marketing
73,229,758
217,938,501
291,168,259
22.1%
1.8%
Underwriting
13,073,156
6,226,792
19,299,948
1.5%
0.1%
Regulatory Compliance and
Government
10,821,817
16,315,540
27,137,357
2.1%
0.2%
433,136
419,847
852,983
0.1%
0.0%
Provider Relations and Contracting
33,827,774
33,476,101
67,303,875
5.1%
0.4%
Quality Assurance and Utilization
Management
61,248,952
44,732,373
105,981,325
8.0%
0.6%
Wellness and Health Education
6,833,228
40,444,893
47,278,121
3.6%
0.3%
Research and Product Development
7,935,541
10,028,946
17,964,487
1.4%
0.1%
5,189
4,965,265
4,970,454
0.4%
0.0%
General Administration
149,924,185
170,003,144
319,927,329
24.2%
2.0%
Total
532,250,026
787,842,758
1,320,092,784
100.0%
8.1%
Detection and Prevention of Fraud
Lobbying
Charitable Contributions
Taxes and Assessments, 2008
MinnesotaCare Tax
141,522,369
Other Taxes and Assessments
266,138,073
Capital Costs
2008 Incurred
2008 Payments
Capital Costs on Behalf of a Hospital or
Clinic
13,866,985
14,070,368
Capital Acquisitions
74,194,654
74,111,610
Other Capital Costs
11,590
11,590
88,073,229
88,193,568
Total Capital Expenditures
2008 Administrative Spending:
American Family Mutual Insurance Company
Total Administrative Spending as percent of Total Carrier Spending1:
29.0%
Commercial Administrative Spending as percent of Commercial Spending:
30.4%
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
Not Applicable
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
22.9%
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Billing and Enrollment
Calendar Year 2008
Salaries and Benefits
Total Indirect Health Care
Expense (by category)
Other Expense
126,954
277,857
404,811
5,156
336,898
342,054
0
0
1,136
536
1,672
53,420
1,317,516
1,370,936
0
0
11,257
128,355
0
0
3,752
1,772
5,524
52,297
24,690
76,987
271
128
399
Research and Product Development
3,665
1,730
5,395
Charitable Contributions
5,105
2,410
7,515
General Administration
680,373
507,524
1,187,897
Total Indirect Health Care Expenses
943,386
2,599,416
3,542,802
Claim Processing
Detection and Prevention of Fraud
Customer Service
Product Management and Marketing
Underwriting
Regulatory Compliance and Government
Lobbying
Provider Relations and Contracting
Quality Assurance and Utilization
Management
Wellness and Health Education
Taxes and Assessments
139,612
Calendar Year 2008
MinnesotaCare Tax
Other Taxes and Assessments
1,209,481
Capital Costs
Calendar Year 2008
2008 Incurred
Capital Costs on Behalf of a Hospital or
Clinic
Capital Acquisitions
Other Capital Costs
Total Capital Expenditures
2008 Payments
2008 Administrative Spending:
Ameritas Life Insurance Corp
Total Administrative Spending as percent of Total Carrier Spending1:
14.5%
Commercial Administrative Spending as percent of Commercial Spending:
14.5%
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
Not Applicable
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
Not Applicable
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Calendar Year 2008
Salaries and Benefits
Other Expense
Total Indirect Health Care
Expense (by category)
Billing and Enrollment
Claim Processing
Detection and Prevention of Fraud
Customer Service
Product Management and Marketing
Underwriting
Regulatory Compliance and Government
Lobbying
Provider Relations and Contracting
Quality Assurance and Utilization
Management
Wellness and Health Education
Research and Product Development
Charitable Contributions
General Administration
447,019
447,019
Total Indirect Health Care Expenses
447,019
447,019
Taxes and Assessments
Calendar Year 2008
MinnesotaCare Tax
Other Taxes and Assessments
77,720
Capital Costs
Calendar Year 2008
2008 Incurred
Capital Costs on Behalf of a Hospital or
Clinic
Capital Acquisitions
Other Capital Costs
Total Capital Expenditures
2008 Payments
2008 Administrative Spending:
Bankers Life and Casualty Company
Total Administrative Spending as percent of Total Carrier Spending1:
15.6%
2.3%
Commercial Administrative Spending as percent of Commercial Spending:
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
Not Applicable
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
18.0%
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Billing and Enrollment
Calendar Year 2008
Salaries and Benefits
Total Indirect Health Care
Expense (by category)
Other Expense
3,423
6,196
9,619
Claim Processing
73,254
132,616
205,870
Detection and Prevention of Fraud
15,325
27,744
43,069
Customer Service
40,099
72,597
112,696
313,357
567,293
880,650
51,083
92,480
143,563
Regulatory Compliance and Government
5,568
10,080
15,648
Lobbying
1,533
2,774
4,307
Provider Relations and Contracting
0
0
Quality Assurance and Utilization
Management
0
0
409
740
1,149
11,289
20,438
31,727
0
0
83,164
150,557
233,721
598,504
1,083,515
1,682,019
Product Management and Marketing
Underwriting
Wellness and Health Education
Research and Product Development
Charitable Contributions
General Administration
Total Indirect Health Care Expenses
Taxes and Assessments
Calendar Year 2008
MinnesotaCare Tax
Other Taxes and Assessments
1,711,622
Capital Costs
Calendar Year 2008
2008 Incurred
Capital Costs on Behalf of a Hospital or
Clinic
Capital Acquisitions
Other Capital Costs
Total Capital Expenditures
2008 Payments
2008 Administrative Spending:
Blue Cross Blue Shield of Minnesota
Total Administrative Spending as percent of Total Carrier Spending1:
8.9%
Commercial Administrative Spending as percent of Commercial Spending:
8.6%
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
Not Applicable
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
16.4%
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Calendar Year 2008
Salaries and Benefits
Total Indirect Health Care
Expense (by category)
Other Expense
Billing and Enrollment
10,916,686
7,204,751
18,121,437
Claim Processing
36,844,105
38,262,439
75,106,544
235,356
81,362
316,718
Customer Service
18,365,763
9,402,017
27,767,780
Product Management and Marketing
13,465,343
90,017,918
103,483,261
4,198,912
1,264,302
5,463,214
469,344
351,353
820,697
13,758
43,159
56,917
Provider Relations and Contracting
17,227,576
12,568,870
29,796,446
Quality Assurance and Utilization
Management
10,139,573
6,334,431
16,474,004
701,182
24,457,290
25,158,472
3,023,063
2,815,056
5,838,119
0
311,108
311,108
31,472,820
37,526,083
68,998,903
147,073,481
230,640,139
377,713,620
Detection and Prevention of Fraud
Underwriting
Regulatory Compliance and Government
Lobbying
Wellness and Health Education
Research and Product Development
Charitable Contributions
General Administration
Total Indirect Health Care Expenses
Taxes and Assessments
Calendar Year 2008
MinnesotaCare Tax
69,196,683
Other Taxes and Assessments
74,242,336
Capital Costs
Calendar Year 2008
2008 Incurred
Capital Costs on Behalf of a Hospital or
Clinic
2008 Payments
0
0
Capital Acquisitions
55,842,000
55,842,000
Other Capital Costs
0
0
55,842,000
55,842,000
Total Capital Expenditures
2008 Administrative Spending:
Blue Plus
Total Administrative Spending as percent of Total Carrier Spending1:
6.8%
11.6%
Commercial Administrative Spending as percent of Commercial Spending:
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
6.6%
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
12.1%
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Calendar Year 2008
Salaries and Benefits
Total Indirect Health Care
Expense (by category)
Other Expense
Billing and Enrollment
1,338,312
788,123
2,126,435
Claim Processing
6,669,535
8,727,519
15,397,054
23,573
8,258
31,831
Customer Service
2,214,263
839,243
3,053,506
Product Management and Marketing
3,972,617
7,367,381
11,339,998
309,546
84,051
393,597
56,198
177,636
233,834
3,206
11,086
14,292
Provider Relations and Contracting
1,505,803
663,241
2,169,044
Quality Assurance and Utilization
Management
4,903,223
2,023,335
6,926,558
Wellness and Health Education
296,204
6,193,331
6,489,535
Research and Product Development
630,852
595,734
1,226,586
0
52,157
52,157
6,130,299
10,723,955
16,854,254
28,053,631
38,255,050
66,308,681
Detection and Prevention of Fraud
Underwriting
Regulatory Compliance and Government
Lobbying
Charitable Contributions
General Administration
Total Indirect Health Care Expenses
Taxes and Assessments
Calendar Year 2008
MinnesotaCare Tax
18,147,250
Other Taxes and Assessments
13,784,347
Capital Costs
Calendar Year 2008
2008 Incurred
2008 Payments
Capital Costs on Behalf of a Hospital or
Clinic
0
0
Capital Acquisitions
0
0
Other Capital Costs
0
0
Total Capital Expenditures
2008 Administrative Spending:
Combined Insurance Company of America
Total Administrative Spending as percent of Total Carrier Spending1:
19.7%
Commercial Administrative Spending as percent of Commercial Spending:
Not Applicable
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
Not Applicable
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
19.7%
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Salaries and Benefits
Calendar Year 2008
Other Expense
Total Indirect Health Care
Expense (by category)
Billing and Enrollment
Claim Processing
Detection and Prevention of Fraud
Customer Service
Product Management and Marketing
Underwriting
Regulatory Compliance and Government
Lobbying
Provider Relations and Contracting
Quality Assurance and Utilization
Management
Wellness and Health Education
Research and Product Development
Charitable Contributions
General Administration
1,012,019
1,012,019
Total Indirect Health Care Expenses
1,012,019
1,012,019
Taxes and Assessments
Calendar Year 2008
MinnesotaCare Tax
Other Taxes and Assessments
Capital Costs
Calendar Year 2008
2008 Incurred
Capital Costs on Behalf of a Hospital or
Clinic
Capital Acquisitions
Other Capital Costs
Total Capital Expenditures
2008 Payments
2008 Administrative Spending:
Companion Life Insurance Company
Total Administrative Spending as percent of Total Carrier Spending1:
8.8%
Commercial Administrative Spending as percent of Commercial Spending:
8.5%
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
Not Applicable
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
Not Applicable
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Calendar Year 2008
Salaries and Benefits
Other Expense
Total Indirect Health Care
Expense (by category)
Billing and Enrollment
12,650
12,650
Claim Processing
18,054
18,054
7,929
7,929
Product Management and Marketing
15,878
15,878
Underwriting
13,712
13,712
5,168
5,168
Detection and Prevention of Fraud
Customer Service
Regulatory Compliance and Government
Lobbying
Provider Relations and Contracting
Quality Assurance and Utilization
Management
Wellness and Health Education
Research and Product Development
Charitable Contributions
12,416
12,416
General Administration
62,084
62,084
74,500
147,891
Total Indirect Health Care Expenses
73,391
Taxes and Assessments
Calendar Year 2008
MinnesotaCare Tax
Other Taxes and Assessments
Capital Costs
Calendar Year 2008
2008 Incurred
Capital Costs on Behalf of a Hospital or
Clinic
Capital Acquisitions
Other Capital Costs
Total Capital Expenditures
2008 Payments
2008 Administrative Spending:
Connecticut General Life Insurance Company
Total Administrative Spending as percent of Total Carrier Spending1:
7.9%
11.1%
Commercial Administrative Spending as percent of Commercial Spending:
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
Not Applicable
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
7.5%
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Calendar Year 2008
Salaries and Benefits
Other Expense
Total Indirect Health Care
Expense (by category)
Billing and Enrollment
2,327,776
2,946,419
5,274,195
Claim Processing
4,031,543
5,102,989
9,134,532
872,640
1,104,558
1,977,198
1,302,893
1,649,157
2,952,050
11,032
13,964
24,996
430,252
544,599
974,851
22,064
27,928
49,992
55,161
69,820
124,981
1,978,058
2,503,758
4,481,816
11,031,419
13,963,192
24,994,611
Detection and Prevention of Fraud
Customer Service
Product Management and Marketing
Underwriting
Regulatory Compliance and Government
Lobbying
Provider Relations and Contracting
Quality Assurance and Utilization
Management
Wellness and Health Education
Research and Product Development
Charitable Contributions
General Administration
Total Indirect Health Care Expenses
Taxes and Assessments
Calendar Year 2008
MinnesotaCare Tax
Other Taxes and Assessments
522,791
Capital Costs
Calendar Year 2008
2008 Incurred
Capital Costs on Behalf of a Hospital or
Clinic
Capital Acquisitions
Other Capital Costs
Total Capital Expenditures
2008 Payments
2008 Administrative Spending:
Delta Dental Plan of Minnesota
Total Administrative Spending as percent of Total Carrier Spending1:
5.9%
Commercial Administrative Spending as percent of Commercial Spending:
9.2%
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
Not Applicable
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
Not Applicable
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Calendar Year 2008
Salaries and Benefits
Total Indirect Health Care
Expense (by category)
Other Expense
Billing and Enrollment
15,885
3,926,895
3,942,780
Claim Processing
15,885
7,521,961
7,537,846
0
639,776
639,776
566,688
9,091,185
9,657,873
4,311,108
7,861,163
12,172,271
0
1,053,106
1,053,106
31,771
2,220,316
2,252,087
0
63,186
63,186
31,771
2,449,544
2,481,315
0
1,497,468
1,497,468
15,884
737,730
753,614
550,802
752,297
1,303,099
0
463,367
463,367
127,083
7,490,844
7,617,927
5,666,877
45,768,838
51,435,715
Detection and Prevention of Fraud
Customer Service
Product Management and Marketing
Underwriting
Regulatory Compliance and Government
Lobbying
Provider Relations and Contracting
Quality Assurance and Utilization
Management
Wellness and Health Education
Research and Product Development
Charitable Contributions
General Administration
Total Indirect Health Care Expenses
Taxes and Assessments
MinnesotaCare Tax
Other Taxes and Assessments
Calendar Year 2008
18,106,881
3,415
Capital Costs
Calendar Year 2008
2008 Incurred
Capital Costs on Behalf of a Hospital or
Clinic
2008 Payments
0
0
Capital Acquisitions
22,568
22,568
Other Capital Costs
0
0
22,568
22,568
Total Capital Expenditures
2008 Administrative Spending:
Federated Mutual Insurance Company
Total Administrative Spending as percent of Total Carrier Spending1:
11.7%
Commercial Administrative Spending as percent of Commercial Spending:
11.7%
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
Not Applicable
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
Not Applicable
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Billing and Enrollment
Calendar Year 2008
Salaries and Benefits
Total Indirect Health Care
Expense (by category)
Other Expense
98,578
29,333
127,911
1,108,205
602,833
1,711,038
0
296
296
53,268
10,160
63,428
1,706,644
429,752
2,136,396
633,588
1,171,977
1,805,565
31,492
6,263
37,755
Lobbying
0
0
Provider Relations and Contracting
0
0
15,917
3,021
18,938
4,415
1,213
5,628
103,740
15,163
118,903
General Administration
1,907,851
539,480
2,447,331
Total Indirect Health Care Expenses
5,663,698
2,809,491
8,473,189
Claim Processing
Detection and Prevention of Fraud
Customer Service
Product Management and Marketing
Underwriting
Regulatory Compliance and Government
Quality Assurance and Utilization
Management
Wellness and Health Education
Research and Product Development
Charitable Contributions
Taxes and Assessments
Calendar Year 2008
MinnesotaCare Tax
Other Taxes and Assessments
2,954,814
Capital Costs
Calendar Year 2008
2008 Incurred
2008 Payments
Capital Costs on Behalf of a Hospital or
Clinic
0
0
Capital Acquisitions
0
0
Other Capital Costs
0
0
Total Capital Expenditures
2008 Administrative Spending:
First Health Life & Health Insurance Company
Total Administrative Spending as percent of Total Carrier Spending1:
6.1%
12.0%
Commercial Administrative Spending as percent of Commercial Spending:
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
Not Applicable
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
6.1%
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Calendar Year 2008
Salaries and Benefits
Other Expense
Total Indirect Health Care
Expense (by category)
Billing and Enrollment
Claim Processing
Detection and Prevention of Fraud
Customer Service
Product Management and Marketing
Underwriting
Regulatory Compliance and Government
Lobbying
Provider Relations and Contracting
Quality Assurance and Utilization
Management
Wellness and Health Education
Research and Product Development
Charitable Contributions
General Administration
87,307
815,372
902,679
Total Indirect Health Care Expenses
87,307
815,372
902,679
Taxes and Assessments
Calendar Year 2008
MinnesotaCare Tax
Other Taxes and Assessments
91,270
Capital Costs
Calendar Year 2008
2008 Incurred
Capital Costs on Behalf of a Hospital or
Clinic
Capital Acquisitions
Other Capital Costs
Total Capital Expenditures
2008 Payments
2008 Administrative Spending:
FirstSolutions
Total Administrative Spending as percent of Total Carrier Spending1:
5.9%
Commercial Administrative Spending as percent of Commercial Spending:
4.1%
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
6.2%
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
Not Applicable
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Billing and Enrollment
Calendar Year 2008
Salaries and Benefits
Total Indirect Health Care
Expense (by category)
Other Expense
2,554
17,956
20,510
554,639
257,789
812,428
1,400
25,448
26,848
Customer Service
300,858
29,609
330,467
Product Management and Marketing
237,496
549,219
786,715
0
19,826
19,826
136,436
312,395
448,831
0
2,729
2,729
Provider Relations and Contracting
287,982
116,995
404,977
Quality Assurance and Utilization
Management
208,778
174,780
383,558
Wellness and Health Education
644,649
152,538
797,187
Research and Product Development
0
0
Charitable Contributions
0
21,821
21,821
General Administration
1,863,513
650,528
2,514,041
Total Indirect Health Care Expenses
4,238,305
2,331,633
6,569,938
Claim Processing
Detection and Prevention of Fraud
Underwriting
Regulatory Compliance and Government
Lobbying
Taxes and Assessments
Calendar Year 2008
MinnesotaCare Tax
656,375
Other Taxes and Assessments
401,170
Capital Costs
Calendar Year 2008
2008 Incurred
2008 Payments
Capital Costs on Behalf of a Hospital or
Clinic
691,466
691,466
Capital Acquisitions
105,769
105,769
797,235
797,235
Other Capital Costs
Total Capital Expenditures
2008 Administrative Spending:
Great-West Life & Annuity Insurance Company
Total Administrative Spending as percent of Total Carrier Spending1:
7.9%
Commercial Administrative Spending as percent of Commercial Spending:
7.9%
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
Not Applicable
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
Not Applicable
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Billing and Enrollment
Calendar Year 2008
Salaries and Benefits
Total Indirect Health Care
Expense (by category)
Other Expense
4,482
87,184
91,666
Claim Processing
0
438,421
438,421
Detection and Prevention of Fraud
0
0
Customer Service
7,821
167,099
174,920
Product Management and Marketing
4,192
285,984
290,176
76,228
0
76,228
1,939
3,508
5,447
0
0
Provider Relations and Contracting
1,051
21,444
22,495
Quality Assurance and Utilization
Management
8,239
91,880
100,119
525
7,365
7,890
Research and Product Development
0
0
Charitable Contributions
0
0
General Administration
0
0
104,477
1,102,885
Underwriting
Regulatory Compliance and Government
Lobbying
Wellness and Health Education
Total Indirect Health Care Expenses
Taxes and Assessments
1,207,362
Calendar Year 2008
MinnesotaCare Tax
Other Taxes and Assessments
25,132
Capital Costs
Calendar Year 2008
2008 Incurred
Capital Costs on Behalf of a Hospital or
Clinic
Capital Acquisitions
Other Capital Costs
Total Capital Expenditures
2008 Payments
2008 Administrative Spending:
Guarantee Trust Life Insurance Company
Total Administrative Spending as percent of Total Carrier Spending1:
22.2%
Commercial Administrative Spending as percent of Commercial Spending:
22.3%
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
Not Applicable
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
21.7%
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Billing and Enrollment
Calendar Year 2008
Salaries and Benefits
Total Indirect Health Care
Expense (by category)
Other Expense
18,486
13,561
32,047
241,788
1,456,120
1,697,908
0
0
Customer Service
930,088
507,015
1,437,103
Product Management and Marketing
103,909
117,248
221,157
Underwriting
71,761
19,389
91,150
Regulatory Compliance and Government
78,437
21,320
99,757
Lobbying
0
1,607
1,607
Provider Relations and Contracting
0
Quality Assurance and Utilization
Management
0
Wellness and Health Education
0
Research and Product Development
0
Charitable Contributions
0
1,815
1,815
383,430
224,554
607,984
1,827,899
2,362,629
4,190,528
Claim Processing
Detection and Prevention of Fraud
General Administration
Total Indirect Health Care Expenses
Taxes and Assessments
Calendar Year 2008
MinnesotaCare Tax
Other Taxes and Assessments
Capital Costs
Calendar Year 2008
2008 Incurred
Capital Costs on Behalf of a Hospital or
Clinic
Capital Acquisitions
Other Capital Costs
Total Capital Expenditures
2008 Payments
2008 Administrative Spending:
Guardian Life Insurance Company of America
Total Administrative Spending as percent of Total Carrier Spending1:
4.5%
Commercial Administrative Spending as percent of Commercial Spending:
6.3%
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
Not Applicable
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
Not Applicable
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Calendar Year 2008
Salaries and Benefits
Total Indirect Health Care
Expense (by category)
Other Expense
Billing and Enrollment
38,446
48,162
86,608
Claim Processing
21,967
32,555
54,522
1,172
448
1,620
Customer Service
21,304
9,778
31,082
Product Management and Marketing
57,004
393,419
450,423
0
0
4,555
6,942
Lobbying
0
0
Provider Relations and Contracting
0
0
Quality Assurance and Utilization
Management
0
12,160
Wellness and Health Education
0
0
Research and Product Development
0
0
Charitable Contributions
0
0
34,727
50,836
85,563
179,175
554,300
733,475
Detection and Prevention of Fraud
Underwriting
Regulatory Compliance and Government
General Administration
Total Indirect Health Care Expenses
Taxes and Assessments
11,497
12,160
Calendar Year 2008
MinnesotaCare Tax
5
Other Taxes and Assessments
Capital Costs
Calendar Year 2008
2008 Incurred
Capital Costs on Behalf of a Hospital or
Clinic
Capital Acquisitions
Other Capital Costs
Total Capital Expenditures
2008 Payments
2008 Administrative Spending:
HCC Life Insurance Company
Total Administrative Spending as percent of Total Carrier Spending1:
7.1%
Commercial Administrative Spending as percent of Commercial Spending:
Not Applicable
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
Not Applicable
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
Not Applicable
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Billing and Enrollment
Calendar Year 2008
Salaries and Benefits
Total Indirect Health Care
Expense (by category)
Other Expense
125,183
38,323
163,506
28,547
8,739
37,286
Detection and Prevention of Fraud
0
0
Customer Service
0
0
Product Management and Marketing
107,852
33,018
140,870
Underwriting
210,170
64,341
274,511
Regulatory Compliance and Government
0
0
Lobbying
0
0
Provider Relations and Contracting
0
0
Quality Assurance and Utilization
Management
0
0
Wellness and Health Education
0
0
Research and Product Development
0
0
Charitable Contributions
0
0
General Administration
255,756
78,297
334,053
Total Indirect Health Care Expenses
727,508
222,718
950,226
Claim Processing
Taxes and Assessments
Calendar Year 2008
MinnesotaCare Tax
Other Taxes and Assessments
0
643,708
Capital Costs
Calendar Year 2008
2008 Incurred
Capital Costs on Behalf of a Hospital or
Clinic
Capital Acquisitions
Other Capital Costs
Total Capital Expenditures
2008 Payments
2008 Administrative Spending:
HealthPartners
Total Administrative Spending as percent of Total Carrier Spending1:
7.3%
Commercial Administrative Spending as percent of Commercial Spending:
7.9%
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
5.4%
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
6.3%
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Billing and Enrollment
Calendar Year 2008
Salaries and Benefits
Total Indirect Health Care
Expense (by category)
Other Expense
6,452,010
2,503,960
8,955,970
16,975,314
3,171,293
20,146,607
520,242
145,254
665,496
9,583,531
170,666
9,754,197
17,697,021
11,089,068
28,786,089
Underwriting
4,101,169
265,944
4,367,113
Regulatory Compliance and Government
1,463,652
1,514,615
2,978,267
269,000
0
269,000
3,369,680
214,876
3,584,556
24,640,203
9,505,628
34,145,831
Wellness and Health Education
1,832,545
4,399,391
6,231,936
Research and Product Development
1,337,860
69,712
1,407,572
0
3,166,711
3,166,711
47,999,686
44,531,792
92,531,478
136,241,913
80,748,910
216,990,823
Claim Processing
Detection and Prevention of Fraud
Customer Service
Product Management and Marketing
Lobbying
Provider Relations and Contracting
Quality Assurance and Utilization
Management
Charitable Contributions
General Administration
Total Indirect Health Care Expenses
Taxes and Assessments
Calendar Year 2008
MinnesotaCare Tax
21,622,444
Other Taxes and Assessments
79,790,000
Capital Costs
Calendar Year 2008
2008 Incurred
2008 Payments
Capital Costs on Behalf of a Hospital or
Clinic
13,175,519
13,378,902
Capital Acquisitions
14,817,540
15,166,931
27,993,059
28,545,833
Other Capital Costs
Total Capital Expenditures
2008 Administrative Spending:
Humana Insurance Company
Total Administrative Spending as percent of Total Carrier Spending1:
12.3%
Commercial Administrative Spending as percent of Commercial Spending:
12.3%
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
Not Applicable
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
12.3%
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Billing and Enrollment
Claim Processing
Calendar Year 2008
Salaries and Benefits
Other Expense
Total Indirect Health Care
Expense (by category)
780,085
9,750,776
10,530,861
73,884
923,529
997,413
83,359
1,041,961
1,125,320
1,291,653
16,145,189
17,436,842
11,058
138,216
149,274
361,267
4,515,704
4,876,971
156,590
1,957,321
2,113,911
75,941
949,238
1,025,179
29,755
371,929
401,684
2,863,592
35,793,863
38,657,455
Detection and Prevention of Fraud
Customer Service
Product Management and Marketing
Underwriting
Regulatory Compliance and Government
Lobbying
Provider Relations and Contracting
Quality Assurance and Utilization
Management
Wellness and Health Education
Research and Product Development
Charitable Contributions
General Administration
Total Indirect Health Care Expenses
Taxes and Assessments
MinnesotaCare Tax
Calendar Year 2008
3,005,738
Other Taxes and Assessments
Capital Costs
Calendar Year 2008
2008 Incurred
Capital Costs on Behalf of a Hospital or
Clinic
Capital Acquisitions
Other Capital Costs
Total Capital Expenditures
2008 Payments
2008 Administrative Spending:
HumanaDental Insurance Company
Total Administrative Spending as percent of Total Carrier Spending1:
35.7%
Commercial Administrative Spending as percent of Commercial Spending:
35.7%
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
Not Applicable
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
Not Applicable
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Calendar Year 2008
Salaries and Benefits
Total Indirect Health Care
Expense (by category)
Other Expense
Billing and Enrollment
27,853
234,984
262,837
Claim Processing
27,657
233,332
260,989
1,565
13,206
14,771
31,874
268,908
300,782
0
0
4,569
38,550
43,119
2,581
21,773
24,354
0
0
609
5,136
5,745
96,708
815,889
912,597
Detection and Prevention of Fraud
Customer Service
Product Management and Marketing
Underwriting
Regulatory Compliance and Government
Lobbying
Provider Relations and Contracting
Quality Assurance and Utilization
Management
Wellness and Health Education
Research and Product Development
Charitable Contributions
General Administration
Total Indirect Health Care Expenses
Taxes and Assessments
Calendar Year 2008
MinnesotaCare Tax
Other Taxes and Assessments
90,541
Capital Costs
Calendar Year 2008
2008 Incurred
Capital Costs on Behalf of a Hospital or
Clinic
Capital Acquisitions
Other Capital Costs
Total Capital Expenditures
2008 Payments
2008 Administrative Spending:
Itasca Medical Care
Total Administrative Spending as percent of Total Carrier Spending1:
9.7%
Not Applicable
Commercial Administrative Spending as percent of Commercial Spending:
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
9.7%
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
Not Applicable
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Billing and Enrollment
Claim Processing
Calendar Year 2008
Salaries and Benefits
Other Expense
Total Indirect Health Care
Expense (by category)
63,383
100,948
164,331
240,856
383,604
624,460
126,767
201,896
328,663
63,383
100,948
164,331
367,570
367,570
595,803
948,913
1,544,716
177,473
282,655
460,128
1,267,665
2,386,534
3,654,199
Detection and Prevention of Fraud
Customer Service
Product Management and Marketing
Underwriting
Regulatory Compliance and Government
Lobbying
Provider Relations and Contracting
Quality Assurance and Utilization
Management
Wellness and Health Education
Research and Product Development
Charitable Contributions
General Administration
Total Indirect Health Care Expenses
Taxes and Assessments
MinnesotaCare Tax
Calendar Year 2008
85,980
Other Taxes and Assessments
Capital Costs
Calendar Year 2008
2008 Incurred
Capital Costs on Behalf of a Hospital or
Clinic
Capital Acquisitions
Other Capital Costs
Total Capital Expenditures
2008 Payments
2008 Administrative Spending:
John Alden Life Insurance Company
Total Administrative Spending as percent of Total Carrier Spending1:
18.7%
Commercial Administrative Spending as percent of Commercial Spending:
18.8%
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
Not Applicable
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
0.0%
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Calendar Year 2008
Salaries and Benefits
Total Indirect Health Care
Expense (by category)
Other Expense
Billing and Enrollment
12,883
10,346
23,229
Claim Processing
31,941
47,273
79,214
0
0
27,274
12,325
39,599
164,102
133,103
297,205
Underwriting
62,625
25,590
88,215
Regulatory Compliance and Government
20,686
17,735
38,421
Lobbying
0
0
Provider Relations and Contracting
0
0
Quality Assurance and Utilization
Management
0
161
Wellness and Health Education
0
0
6,591
1,526
8,117
0
757
757
53,908
380,035
433,943
380,010
628,851
1,008,861
Detection and Prevention of Fraud
Customer Service
Product Management and Marketing
Research and Product Development
Charitable Contributions
General Administration
Total Indirect Health Care Expenses
Taxes and Assessments
Calendar Year 2008
MinnesotaCare Tax
Other Taxes and Assessments
734
139,669
Capital Costs
Calendar Year 2008
2008 Incurred
2008 Payments
Capital Costs on Behalf of a Hospital or
Clinic
0
0
Capital Acquisitions
0
0
Other Capital Costs
0
0
Total Capital Expenditures
161
2008 Administrative Spending:
Lincoln National Life Insurance Company
Total Administrative Spending as percent of Total Carrier Spending1:
4.4%
Commercial Administrative Spending as percent of Commercial Spending:
4.4%
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
Not Applicable
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
Not Applicable
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Salaries and Benefits
Calendar Year 2008
Other Expense
Total Indirect Health Care
Expense (by category)
Billing and Enrollment
Claim Processing
Detection and Prevention of Fraud
Customer Service
Product Management and Marketing
Underwriting
Regulatory Compliance and Government
Lobbying
Provider Relations and Contracting
Quality Assurance and Utilization
Management
Wellness and Health Education
Research and Product Development
Charitable Contributions
General Administration
219,176
219,176
Total Indirect Health Care Expenses
219,176
219,176
Taxes and Assessments
Calendar Year 2008
MinnesotaCare Tax
Other Taxes and Assessments
Capital Costs
Calendar Year 2008
2008 Incurred
Capital Costs on Behalf of a Hospital or
Clinic
Capital Acquisitions
Other Capital Costs
Total Capital Expenditures
2008 Payments
2008 Administrative Spending:
Medica Health Plans
Total Administrative Spending as percent of Total Carrier Spending1:
6.5%
Commercial Administrative Spending as percent of Commercial Spending:
5.2%
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
6.6%
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
9.8%
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Calendar Year 2008
Salaries and Benefits
Total Indirect Health Care
Expense (by category)
Other Expense
Billing and Enrollment
1,165,684
5,563,297
6,728,981
Claim Processing
1,283,900
9,792,223
11,076,123
91,941
51,685
143,626
Customer Service
3,213,605
2,240,267
5,453,872
Product Management and Marketing
3,174,006
2,950,642
6,124,648
Underwriting
244,178
137,266
381,444
Regulatory Compliance and Government
631,746
582,008
1,213,754
15,149
8,516
23,665
977,155
827,023
1,804,178
1,105,114
2,522,201
3,627,315
Wellness and Health Education
419,464
235,805
655,269
Research and Product Development
288,992
905,787
1,194,779
0
0
General Administration
10,750,959
15,632,634
26,383,593
Total Indirect Health Care Expenses
23,361,893
41,449,354
64,811,247
Detection and Prevention of Fraud
Lobbying
Provider Relations and Contracting
Quality Assurance and Utilization
Management
Charitable Contributions
Taxes and Assessments
Calendar Year 2008
MinnesotaCare Tax
Other Taxes and Assessments
0
15,283,861
Capital Costs
Calendar Year 2008
2008 Incurred
2008 Payments
Capital Costs on Behalf of a Hospital or
Clinic
0
0
Capital Acquisitions
0
0
Other Capital Costs
0
0
Total Capital Expenditures
2008 Administrative Spending:
Medica Insurance Company
Total Administrative Spending as percent of Total Carrier Spending1:
11.0%
Commercial Administrative Spending as percent of Commercial Spending:
11.1%
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
Not Applicable
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
10.0%
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Calendar Year 2008
Salaries and Benefits
Total Indirect Health Care
Expense (by category)
Other Expense
Billing and Enrollment
2,403,368
9,820,635
12,224,003
Claim Processing
2,647,102
17,140,683
19,787,785
189,560
106,563
296,123
Customer Service
6,625,701
4,473,135
11,098,836
Product Management and Marketing
6,544,058
39,462,782
46,006,840
503,437
283,011
786,448
1,302,513
1,166,663
2,469,176
31,234
17,558
48,792
Provider Relations and Contracting
2,014,664
1,611,790
3,626,454
Quality Assurance and Utilization
Management
2,278,486
1,783,646
4,062,132
Wellness and Health Education
864,837
486,175
1,351,012
Research and Product Development
595,834
1,617,688
2,213,522
0
0
General Administration
22,165,962
12,967,584
35,133,546
Total Indirect Health Care Expenses
48,166,756
90,937,913
139,104,669
Detection and Prevention of Fraud
Underwriting
Regulatory Compliance and Government
Lobbying
Charitable Contributions
Taxes and Assessments
Calendar Year 2008
MinnesotaCare Tax
Other Taxes and Assessments
0
55,512,150
Capital Costs
Calendar Year 2008
2008 Incurred
2008 Payments
Capital Costs on Behalf of a Hospital or
Clinic
0
0
Capital Acquisitions
0
0
Other Capital Costs
0
0
Total Capital Expenditures
2008 Administrative Spending:
Medica Self Insured
Total Administrative Spending as percent of Total Carrier Spending1:
4.8%
Commercial Administrative Spending as percent of Commercial Spending:
Not Applicable
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
Not Applicable
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
Not Applicable
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Calendar Year 2008
Salaries and Benefits
Total Indirect Health Care
Expense (by category)
Other Expense
Billing and Enrollment
1,328,843
7,155,862
8,484,705
Claim Processing
1,463,606
12,666,954
14,130,560
104,810
58,920
163,730
Customer Service
2,314,124
1,867,245
4,181,369
Product Management and Marketing
3,618,268
4,078,957
7,697,225
Underwriting
278,355
156,479
434,834
Regulatory Compliance and Government
720,171
701,092
1,421,263
17,269
9,708
26,977
Provider Relations and Contracting
1,113,926
988,832
2,102,758
Quality Assurance and Utilization
Management
1,259,795
1,088,651
2,348,446
Wellness and Health Education
478,176
268,810
746,986
Research and Product Development
329,442
1,155,832
1,485,274
0
0
General Administration
12,228,061
7,256,118
19,484,179
Total Indirect Health Care Expenses
25,254,846
37,453,460
62,708,306
Detection and Prevention of Fraud
Lobbying
Charitable Contributions
Taxes and Assessments
Calendar Year 2008
MinnesotaCare Tax
0
Other Taxes and Assessments
0
Capital Costs
Calendar Year 2008
2008 Incurred
2008 Payments
Capital Costs on Behalf of a Hospital or
Clinic
0
0
Capital Acquisitions
0
0
Other Capital Costs
0
0
Total Capital Expenditures
2008 Administrative Spending:
Metropolitan HealthPlan (MHP)
Total Administrative Spending as percent of Total Carrier Spending1:
19.7%
Not Applicable
Commercial Administrative Spending as percent of Commercial Spending:
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
18.9%
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
22.5%
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Billing and Enrollment
Calendar Year 2008
Salaries and Benefits
Total Indirect Health Care
Expense (by category)
Other Expense
449,118
739,781
1,188,899
3,500,662
5,088,187
8,588,849
258,813
66,544
325,357
1,677,642
608,659
2,286,301
818,704
996,190
1,814,894
0
0
1,560,153
1,348,576
0
0
Provider Relations and Contracting
1,270,396
206,193
1,476,589
Quality Assurance and Utilization
Management
5,027,391
2,292,745
7,320,136
211,880
199,616
411,496
38,381
3,023
41,404
0
259,142
259,142
665,612
4,801,744
5,467,356
15,478,752
16,610,400
32,089,152
Claim Processing
Detection and Prevention of Fraud
Customer Service
Product Management and Marketing
Underwriting
Regulatory Compliance and Government
Lobbying
Wellness and Health Education
Research and Product Development
Charitable Contributions
General Administration
Total Indirect Health Care Expenses
Taxes and Assessments
MinnesotaCare Tax
Other Taxes and Assessments
Calendar Year 2008
1,071,727
506,494
Capital Costs
Calendar Year 2008
2008 Incurred
Capital Costs on Behalf of a Hospital or
Clinic
Capital Acquisitions
432,435
Other Capital Costs
Total Capital Expenditures
2,908,729
432,435
2008 Payments
2008 Administrative Spending:
Metropolitan Life Insurance Company
Total Administrative Spending as percent of Total Carrier Spending1:
8.8%
11.7%
Commercial Administrative Spending as percent of Commercial Spending:
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
Not Applicable
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
Not Applicable
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Billing and Enrollment
Calendar Year 2008
Salaries and Benefits
Total Indirect Health Care
Expense (by category)
Other Expense
185,603
48,845
234,448
88,178
524,579
612,757
2,451
0
2,451
98,838
181,364
280,202
950,206
1,510,602
2,460,808
25,520
6,572
32,092
3,551
19,420
22,971
0
0
23,936
36,213
60,149
4,808
6,687
11,495
61
4
65
Research and Product Development
0
0
Charitable Contributions
0
0
49,490
1,549,991
1,599,481
1,432,642
3,884,277
5,316,919
Claim Processing
Detection and Prevention of Fraud
Customer Service
Product Management and Marketing
Underwriting
Regulatory Compliance and Government
Lobbying
Provider Relations and Contracting
Quality Assurance and Utilization
Management
Wellness and Health Education
General Administration
Total Indirect Health Care Expenses
Taxes and Assessments
Calendar Year 2008
MinnesotaCare Tax
Other Taxes and Assessments
368,487
Capital Costs
Calendar Year 2008
2008 Incurred
Capital Costs on Behalf of a Hospital or
Clinic
Capital Acquisitions
Other Capital Costs
Total Capital Expenditures
2008 Payments
2008 Administrative Spending:
Mutual of Omaha Insurance Company
Total Administrative Spending as percent of Total Carrier Spending1:
13.6%
Commercial Administrative Spending as percent of Commercial Spending:
36.8%
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
Not Applicable
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
13.4%
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Billing and Enrollment
Calendar Year 2008
Salaries and Benefits
Total Indirect Health Care
Expense (by category)
Other Expense
3,694
3,464
7,158
122,878
218,703
341,581
3,096
1,389
4,485
Customer Service
28,135
14,992
43,127
Product Management and Marketing
23,105
827,925
851,030
Underwriting
858
197
1,055
Regulatory Compliance and Government
148
10,763
10,911
Provider Relations and Contracting
1
1
Quality Assurance and Utilization
Management
1
1
300
94
394
89,211
56,995
146,206
271,425
1,134,524
1,405,949
Claim Processing
Detection and Prevention of Fraud
Lobbying
Wellness and Health Education
Research and Product Development
Charitable Contributions
General Administration
Total Indirect Health Care Expenses
Taxes and Assessments
Calendar Year 2008
MinnesotaCare Tax
885,551
Other Taxes and Assessments
280,510
Capital Costs
Calendar Year 2008
2008 Incurred
Capital Costs on Behalf of a Hospital or
Clinic
Capital Acquisitions
Other Capital Costs
Total Capital Expenditures
2008 Payments
2008 Administrative Spending:
Pan-American Life
Total Administrative Spending as percent of Total Carrier Spending1:
1.5%
Commercial Administrative Spending as percent of Commercial Spending:
8.8%
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
Not Applicable
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
Not Applicable
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Calendar Year 2008
Salaries and Benefits
Other Expense
Total Indirect Health Care
Expense (by category)
Billing and Enrollment
Claim Processing
Detection and Prevention of Fraud
Customer Service
Product Management and Marketing
Underwriting
Regulatory Compliance and Government
Lobbying
Provider Relations and Contracting
Quality Assurance and Utilization
Management
Wellness and Health Education
Research and Product Development
Charitable Contributions
General Administration
17,415
32,509
49,924
Total Indirect Health Care Expenses
17,415
32,509
49,924
Taxes and Assessments
Calendar Year 2008
MinnesotaCare Tax
Other Taxes and Assessments
68,280
Capital Costs
Calendar Year 2008
2008 Incurred
Capital Costs on Behalf of a Hospital or
Clinic
Capital Acquisitions
Other Capital Costs
Total Capital Expenditures
2008 Payments
2008 Administrative Spending:
Pennsylvania Life Insurance Company
Total Administrative Spending as percent of Total Carrier Spending1:
13.4%
100.0%
Commercial Administrative Spending as percent of Commercial Spending:
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
Not Applicable
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
9.2%
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Billing and Enrollment
Calendar Year 2008
Salaries and Benefits
Total Indirect Health Care
Expense (by category)
Other Expense
65,024
190,656
255,680
280,006
514,607
794,613
214
249
463
40,897
442,402
483,299
141,407
89,469
230,876
0
0
5,957
14,540
0
0
Provider Relations and Contracting
46,345
103,771
150,116
Quality Assurance and Utilization
Management
59,994
143,567
203,561
0
0
1,515
1,763
0
0
General Administration
180,831
400,028
580,859
Total Indirect Health Care Expenses
822,190
1,901,052
2,723,242
Claim Processing
Detection and Prevention of Fraud
Customer Service
Product Management and Marketing
Underwriting
Regulatory Compliance and Government
Lobbying
Wellness and Health Education
Research and Product Development
Charitable Contributions
Taxes and Assessments
20,497
3,278
Calendar Year 2008
MinnesotaCare Tax
Other Taxes and Assessments
19,634
Capital Costs
Calendar Year 2008
2008 Incurred
Capital Costs on Behalf of a Hospital or
Clinic
Capital Acquisitions
Other Capital Costs
Total Capital Expenditures
2008 Payments
2008 Administrative Spending:
Physicians Mutual Ins. Co. & Physicians Life Ins. Co.
Total Administrative Spending as percent of Total Carrier Spending1:
21.4%
Commercial Administrative Spending as percent of Commercial Spending:
42.4%
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
Not Applicable
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
16.9%
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Calendar Year 2008
Salaries and Benefits
Total Indirect Health Care
Expense (by category)
Other Expense
Billing and Enrollment
22,859
27,737
50,596
Claim Processing
59,410
106,997
166,407
3,412
5,375
8,787
23,186
20,132
43,318
227,308
280,000
507,308
17,842
11,926
29,768
6,426
10,050
16,476
0
0
Provider Relations and Contracting
14,626
17,786
32,412
Quality Assurance and Utilization
Management
50,196
101,090
151,286
0
0
14,375
19,608
0
0
General Administration
158,430
287,974
446,404
Total Indirect Health Care Expenses
598,070
888,675
1,486,745
Detection and Prevention of Fraud
Customer Service
Product Management and Marketing
Underwriting
Regulatory Compliance and Government
Lobbying
Wellness and Health Education
Research and Product Development
Charitable Contributions
Taxes and Assessments
33,983
Calendar Year 2008
MinnesotaCare Tax
Other Taxes and Assessments
316,795
Capital Costs
Calendar Year 2008
2008 Incurred
Capital Costs on Behalf of a Hospital or
Clinic
Capital Acquisitions
Other Capital Costs
Total Capital Expenditures
2008 Payments
2008 Administrative Spending:
PreferredOne Community Health Plan
Total Administrative Spending as percent of Total Carrier Spending1:
11.3%
Commercial Administrative Spending as percent of Commercial Spending:
11.3%
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
Not Applicable
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
Not Applicable
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Calendar Year 2008
Salaries and Benefits
Total Indirect Health Care
Expense (by category)
Other Expense
Billing and Enrollment
419,888
285,806
705,694
Claim Processing
679,987
462,848
1,142,835
98,327
66,928
165,255
619,764
421,856
1,041,620
1,443,121
6,322,903
7,766,024
Underwriting
526,207
358,175
884,382
Regulatory Compliance and Government
335,254
228,198
563,452
11,090
7,549
18,639
Provider Relations and Contracting
482,341
328,316
810,657
Quality Assurance and Utilization
Management
381,908
259,954
641,862
Wellness and Health Education
121,747
1,265,144
1,386,891
Research and Product Development
235,378
160,215
395,593
0
0
840,767
1,040,746
1,881,513
6,195,779
11,208,638
17,404,417
Detection and Prevention of Fraud
Customer Service
Product Management and Marketing
Lobbying
Charitable Contributions
General Administration
Total Indirect Health Care Expenses
Taxes and Assessments
Calendar Year 2008
MinnesotaCare Tax
1,583,584
Other Taxes and Assessments
4,788,764
Capital Costs
Calendar Year 2008
2008 Incurred
Capital Costs on Behalf of a Hospital or
Clinic
Capital Acquisitions
Other Capital Costs
Total Capital Expenditures
2008 Payments
2008 Administrative Spending:
PreferredOne Insurance Company
Total Administrative Spending as percent of Total Carrier Spending1:
14.1%
Commercial Administrative Spending as percent of Commercial Spending:
18.9%
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
Not Applicable
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
Not Applicable
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Calendar Year 2008
Salaries and Benefits
Total Indirect Health Care
Expense (by category)
Other Expense
Billing and Enrollment
45,293
30,829
76,122
Claim Processing
73,349
49,927
123,276
Detection and Prevention of Fraud
10,606
7,219
17,825
Customer Service
66,853
45,505
112,358
155,667
991,398
1,147,065
Underwriting
56,761
38,636
95,397
Regulatory Compliance and Government
36,163
24,615
60,778
1,196
814
2,010
Provider Relations and Contracting
52,029
35,415
87,444
Quality Assurance and Utilization
Management
41,196
28,041
69,237
Wellness and Health Education
13,133
91,354
104,487
Research and Product Development
25,390
17,282
42,672
0
0
90,692
133,311
224,003
668,328
1,494,346
2,162,674
Product Management and Marketing
Lobbying
Charitable Contributions
General Administration
Total Indirect Health Care Expenses
Taxes and Assessments
Calendar Year 2008
MinnesotaCare Tax
377,898
Other Taxes and Assessments
445,626
Capital Costs
Calendar Year 2008
2008 Incurred
Capital Costs on Behalf of a Hospital or
Clinic
Capital Acquisitions
Other Capital Costs
Total Capital Expenditures
2008 Payments
2008 Administrative Spending:
PrimeWest Health System
Total Administrative Spending as percent of Total Carrier Spending1:
15.0%
Not Applicable
Commercial Administrative Spending as percent of Commercial Spending:
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
15.0%
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
Not Applicable
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Billing and Enrollment
Calendar Year 2008
Salaries and Benefits
Total Indirect Health Care
Expense (by category)
Other Expense
234,141
535,517
769,658
1,552,129
4,769,775
6,321,904
Detection and Prevention of Fraud
205,815
167,438
373,253
Customer Service
259,400
202,511
461,911
Product Management and Marketing
0
0
Underwriting
0
0
1,283,482
1,136,419
2,419,901
0
40,798
40,798
783,652
405,885
1,189,537
1,926,434
2,513,150
4,439,584
Wellness and Health Education
175,689
185,381
361,070
Research and Product Development
133,913
209,619
343,532
0
537,136
537,136
367,550
1,830,394
2,197,944
6,922,205
12,534,023
19,456,228
Claim Processing
Regulatory Compliance and Government
Lobbying
Provider Relations and Contracting
Quality Assurance and Utilization
Management
Charitable Contributions
General Administration
Total Indirect Health Care Expenses
Taxes and Assessments
MinnesotaCare Tax
Calendar Year 2008
580,100
Other Taxes and Assessments
Capital Costs
Calendar Year 2008
2008 Incurred
2008 Payments
Capital Costs on Behalf of a Hospital or
Clinic
Capital Acquisitions
1,111,832
1,111,832
Other Capital Costs
11,590
11,590
1,123,422
1,123,422
Total Capital Expenditures
2008 Administrative Spending:
Principal Life Insurance Company
Total Administrative Spending as percent of Total Carrier Spending1:
5.5%
28.6%
Commercial Administrative Spending as percent of Commercial Spending:
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
Not Applicable
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
Not Applicable
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Billing and Enrollment
Calendar Year 2008
Salaries and Benefits
Total Indirect Health Care
Expense (by category)
Other Expense
196,354
84,152
280,506
1,106,823
474,353
1,581,176
0
0
25,560
10,954
36,514
194,133
83,200
277,333
0
0
23,400
10,028
0
0
Provider Relations and Contracting
72,789
31,195
103,984
Quality Assurance and Utilization
Management
84,691
36,296
120,987
0
0
30,209
12,947
0
0
547,493
234,640
782,133
2,281,452
977,765
3,259,217
Claim Processing
Detection and Prevention of Fraud
Customer Service
Product Management and Marketing
Underwriting
Regulatory Compliance and Government
Lobbying
Wellness and Health Education
Research and Product Development
Charitable Contributions
General Administration
Total Indirect Health Care Expenses
Taxes and Assessments
MinnesotaCare Tax
Other Taxes and Assessments
43,156
Calendar Year 2008
596,578
1,819,536
Capital Costs
Calendar Year 2008
2008 Incurred
2008 Payments
Capital Costs on Behalf of a Hospital or
Clinic
0
0
Capital Acquisitions
0
0
Other Capital Costs
0
0
Total Capital Expenditures
33,428
2008 Administrative Spending:
Pyramid Life Insurance Company
Total Administrative Spending as percent of Total Carrier Spending1:
11.3%
100.0%
Commercial Administrative Spending as percent of Commercial Spending:
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
Not Applicable
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
11.1%
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Calendar Year 2008
Salaries and Benefits
Total Indirect Health Care
Expense (by category)
Other Expense
Billing and Enrollment
23,717
65,177
88,894
Claim Processing
29,912
82,201
112,113
Detection and Prevention of Fraud
21,152
58,129
79,281
Customer Service
24,216
66,547
90,763
Product Management and Marketing
38,095
104,688
142,783
0
0
2,264
6,222
0
0
Provider Relations and Contracting
14,297
39,290
53,587
Quality Assurance and Utilization
Management
12,234
33,621
45,855
Wellness and Health Education
9,858
27,090
36,948
Research and Product Development
5,090
13,987
19,077
0
0
General Administration
117,489
322,874
440,363
Total Indirect Health Care Expenses
298,324
819,826
1,118,150
Underwriting
Regulatory Compliance and Government
Lobbying
Charitable Contributions
Taxes and Assessments
8,486
Calendar Year 2008
MinnesotaCare Tax
Other Taxes and Assessments
5,923
Capital Costs
Calendar Year 2008
2008 Incurred
Capital Costs on Behalf of a Hospital or
Clinic
Capital Acquisitions
Other Capital Costs
Total Capital Expenditures
2008 Payments
2008 Administrative Spending:
ReliaStar Life Insurance Company
Total Administrative Spending as percent of Total Carrier Spending1:
9.9%
29.4%
Commercial Administrative Spending as percent of Commercial Spending:
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
Not Applicable
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
100.0%
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Calendar Year 2008
Salaries and Benefits
Total Indirect Health Care
Expense (by category)
Other Expense
Billing and Enrollment
62,304
24,619
86,923
Claim Processing
95,844
30,723
126,567
0
0
31,793
18,382
50,175
299,986
144,989
444,975
Underwriting
67,336
15,816
83,152
Regulatory Compliance and Government
14,138
3,192
17,330
0
0
59,379
36,985
96,364
110,254
105,885
216,139
0
0
12,634
1,757
0
0
505,527
644,451
1,149,978
1,259,195
1,026,799
2,285,994
Detection and Prevention of Fraud
Customer Service
Product Management and Marketing
Lobbying
Provider Relations and Contracting
Quality Assurance and Utilization
Management
Wellness and Health Education
Research and Product Development
Charitable Contributions
General Administration
Total Indirect Health Care Expenses
Taxes and Assessments
Calendar Year 2008
MinnesotaCare Tax
Other Taxes and Assessments
0
652,656
Capital Costs
Calendar Year 2008
2008 Incurred
Capital Costs on Behalf of a Hospital or
Clinic
Capital Acquisitions
Other Capital Costs
Total Capital Expenditures
14,391
2008 Payments
2008 Administrative Spending:
RxAmerica, LLC
Total Administrative Spending as percent of Total Carrier Spending1:
8.5%
Commercial Administrative Spending as percent of Commercial Spending:
Not Applicable
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
Not Applicable
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
8.5%
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Calendar Year 2008
Salaries and Benefits
Total Indirect Health Care
Expense (by category)
Other Expense
Billing and Enrollment
Claim Processing
Detection and Prevention of Fraud
Customer Service
Product Management and Marketing
Underwriting
Regulatory Compliance and Government
Lobbying
Provider Relations and Contracting
Quality Assurance and Utilization
Management
Wellness and Health Education
Research and Product Development
Charitable Contributions
General Administration
567,856
567,856
Total Indirect Health Care Expenses
567,856
567,856
Taxes and Assessments
Calendar Year 2008
MinnesotaCare Tax
0
Other Taxes and Assessments
0
Capital Costs
Calendar Year 2008
2008 Incurred
2008 Payments
Capital Costs on Behalf of a Hospital or
Clinic
0
0
Capital Acquisitions
0
0
Other Capital Costs
0
0
Total Capital Expenditures
2008 Administrative Spending:
Security Life Insurance Company of America
Total Administrative Spending as percent of Total Carrier Spending1:
19.3%
Commercial Administrative Spending as percent of Commercial Spending:
19.3%
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
Not Applicable
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
Not Applicable
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Calendar Year 2008
Salaries and Benefits
Other Expense
Total Indirect Health Care
Expense (by category)
Billing and Enrollment
Claim Processing
Detection and Prevention of Fraud
Customer Service
Product Management and Marketing
64,514
110,526
175,040
Underwriting
23,491
40,245
63,736
4,669
8,000
12,669
11,548
19,784
31,332
General Administration
158,502
271,546
430,048
Total Indirect Health Care Expenses
262,724
450,101
712,825
Regulatory Compliance and Government
Lobbying
Provider Relations and Contracting
Quality Assurance and Utilization
Management
Wellness and Health Education
Research and Product Development
Charitable Contributions
Taxes and Assessments
Calendar Year 2008
MinnesotaCare Tax
Other Taxes and Assessments
Capital Costs
Calendar Year 2008
2008 Incurred
Capital Costs on Behalf of a Hospital or
Clinic
Capital Acquisitions
Other Capital Costs
Total Capital Expenditures
2008 Payments
2008 Administrative Spending:
SilverScript Insurance Company
Total Administrative Spending as percent of Total Carrier Spending1:
4.6%
Commercial Administrative Spending as percent of Commercial Spending:
Not Applicable
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
Not Applicable
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
4.6%
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Calendar Year 2008
Salaries and Benefits
Total Indirect Health Care
Expense (by category)
Other Expense
Billing and Enrollment
RE
412
Claim Processing
RE
RE
Detection and Prevention of Fraud
RE
RE
37,545
5,126
Product Management and Marketing
RE
RE
Underwriting
RE
RE
Regulatory Compliance and Government
RE
RE
0
0
Provider Relations and Contracting
RE
RE
Quality Assurance and Utilization
Management
RE
RE
Wellness and Health Education
0
0
Research and Product Development
0
0
Charitable Contributions
0
0
RE
338,823
338,823
37,545
344,361
381,906
Customer Service
Lobbying
General Administration
Total Indirect Health Care Expenses
Taxes and Assessments
0
1,362
Capital Costs
Calendar Year 2008
2008 Incurred
2008 Payments
Capital Costs on Behalf of a Hospital or
Clinic
0
0
Capital Acquisitions
0
0
Other Capital Costs
0
0
Total Capital Expenditures
42,671
Calendar Year 2008
MinnesotaCare Tax
Other Taxes and Assessments
412
2008 Administrative Spending:
South Country Health Alliance
Total Administrative Spending as percent of Total Carrier Spending1:
9.5%
Not Applicable
Commercial Administrative Spending as percent of Commercial Spending:
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
9.5%
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
Not Applicable
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Billing and Enrollment
Calendar Year 2008
Salaries and Benefits
56,401
Claim Processing
Total Indirect Health Care
Expense (by category)
Other Expense
651,057
707,458
6,122,807
6,122,807
Detection and Prevention of Fraud
110,864
23,268
134,132
Customer Service
319,607
1,747,291
2,066,898
Product Management and Marketing
846,375
1,360,316
2,206,691
Underwriting
Regulatory Compliance and Government
0
48,359
Lobbying
11,038
59,397
73,724
73,724
Provider Relations and Contracting
289,349
1,170,835
1,460,184
Quality Assurance and Utilization
Management
505,602
500,548
1,006,150
73,910
225,512
299,422
Wellness and Health Education
Research and Product Development
0
Charitable Contributions
0
General Administration
1,033,999
2,306,702
3,340,701
Total Indirect Health Care Expenses
3,284,466
14,193,098
17,477,564
Taxes and Assessments
Calendar Year 2008
MinnesotaCare Tax
0
Other Taxes and Assessments
0
Capital Costs
Calendar Year 2008
2008 Incurred
Capital Costs on Behalf of a Hospital or
Clinic
Capital Acquisitions
2008 Payments
0
0
160,581
160,581
160,581
160,581
Other Capital Costs
Total Capital Expenditures
2008 Administrative Spending:
State Farm Mutual Automobile Insurance Company
Total Administrative Spending as percent of Total Carrier Spending1:
14.9%
Commercial Administrative Spending as percent of Commercial Spending:
11.5%
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
Not Applicable
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
22.8%
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Calendar Year 2008
Salaries and Benefits
Total Indirect Health Care
Expense (by category)
Other Expense
Billing and Enrollment
167,880
18,846
186,726
Claim Processing
370,438
658,556
1,028,994
Detection and Prevention of Fraud
19,497
34,661
54,158
Customer Service
48,966
28
48,994
Product Management and Marketing
88,138
1,373,775
1,461,913
9,793
5,300
15,093
97,931
36,014
133,945
0
18,929
18,929
Provider Relations and Contracting
20,986
12
20,998
Quality Assurance and Utilization
Management
48,966
15,545
64,511
6,996
4
7,000
69,951
15,557
85,508
0
104
104
139,901
80,101
220,002
1,089,443
2,257,432
3,346,875
Underwriting
Regulatory Compliance and Government
Lobbying
Wellness and Health Education
Research and Product Development
Charitable Contributions
General Administration
Total Indirect Health Care Expenses
Taxes and Assessments
Calendar Year 2008
MinnesotaCare Tax
Other Taxes and Assessments
20
939,052
Capital Costs
Calendar Year 2008
2008 Incurred
Capital Costs on Behalf of a Hospital or
Clinic
Capital Acquisitions
Other Capital Costs
Total Capital Expenditures
2008 Payments
2008 Administrative Spending:
Sterling Life Insurance Company
Total Administrative Spending as percent of Total Carrier Spending1:
13.8%
Commercial Administrative Spending as percent of Commercial Spending:
Not Applicable
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
Not Applicable
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
13.8%
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Calendar Year 2008
Salaries and Benefits
Total Indirect Health Care
Expense (by category)
Other Expense
Billing and Enrollment
10,953
8,683
19,636
Claim Processing
19,855
7,531
27,386
0
0
Customer Service
14,765
714
15,479
Product Management and Marketing
30,141
72,131
102,272
0
0
2,852
2,714
5,566
0
1,059
1,059
12,440
5,574
18,014
5,868
2,224
8,092
509
2,475
2,984
4,818
44,503
49,321
0
16
16
General Administration
101,945
212,484
314,429
Total Indirect Health Care Expenses
204,146
360,108
564,254
Detection and Prevention of Fraud
Underwriting
Regulatory Compliance and Government
Lobbying
Provider Relations and Contracting
Quality Assurance and Utilization
Management
Wellness and Health Education
Research and Product Development
Charitable Contributions
Taxes and Assessments
Calendar Year 2008
MinnesotaCare Tax
Other Taxes and Assessments
0
6,271
Capital Costs
Calendar Year 2008
2008 Incurred
2008 Payments
Capital Costs on Behalf of a Hospital or
Clinic
0
0
Capital Acquisitions
0
0
Other Capital Costs
0
0
Total Capital Expenditures
2008 Administrative Spending:
Sun Life Assurance Company of Canada
Total Administrative Spending as percent of Total Carrier Spending1:
15.5%
Commercial Administrative Spending as percent of Commercial Spending:
Not Applicable
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
Not Applicable
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
Not Applicable
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Calendar Year 2008
Salaries and Benefits
Total Indirect Health Care
Expense (by category)
Other Expense
Billing and Enrollment
14,535
765
15,300
Claim Processing
23,058
5,620
28,678
0
0
Customer Service
19,380
1,020
20,400
Product Management and Marketing
17,320
912
18,232
Underwriting
47,670
8,042
55,712
969
51
1,020
Lobbying
0
0
Provider Relations and Contracting
0
0
Quality Assurance and Utilization
Management
0
0
Wellness and Health Education
0
0
4,330
228
0
0
General Administration
326,132
33,740
359,872
Total Indirect Health Care Expenses
453,394
50,378
503,772
Detection and Prevention of Fraud
Regulatory Compliance and Government
Research and Product Development
Charitable Contributions
Taxes and Assessments
4,558
Calendar Year 2008
MinnesotaCare Tax
Other Taxes and Assessments
Capital Costs
Calendar Year 2008
2008 Incurred
Capital Costs on Behalf of a Hospital or
Clinic
Capital Acquisitions
Other Capital Costs
Total Capital Expenditures
2008 Payments
2008 Administrative Spending:
Time Insurance Company
Total Administrative Spending as percent of Total Carrier Spending1:
24.0%
Commercial Administrative Spending as percent of Commercial Spending:
24.0%
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
Not Applicable
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
Not Applicable
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Calendar Year 2008
Salaries and Benefits
Total Indirect Health Care
Expense (by category)
Other Expense
Billing and Enrollment
108,727
140,849
249,576
Claim Processing
379,630
348,372
728,002
0
0
296,640
136,061
432,701
1,316,470
1,557,653
2,874,123
Underwriting
844,972
395,759
1,240,731
Regulatory Compliance and Government
209,172
392,922
602,094
Lobbying
0
0
Provider Relations and Contracting
0
0
Quality Assurance and Utilization
Management
0
1,596
Wellness and Health Education
0
0
59,378
18,579
77,957
0
6,276
6,276
446,464
3,611,343
4,057,807
3,661,453
6,609,410
10,270,863
Detection and Prevention of Fraud
Customer Service
Product Management and Marketing
Research and Product Development
Charitable Contributions
General Administration
Total Indirect Health Care Expenses
Taxes and Assessments
MinnesotaCare Tax
Other Taxes and Assessments
Calendar Year 2008
9,961
1,561,307
Capital Costs
Calendar Year 2008
2008 Incurred
2008 Payments
Capital Costs on Behalf of a Hospital or
Clinic
0
0
Capital Acquisitions
0
0
Other Capital Costs
0
0
Total Capital Expenditures
1,596
2008 Administrative Spending:
UCare Minnesota
Total Administrative Spending as percent of Total Carrier Spending1:
6.0%
Not Applicable
Commercial Administrative Spending as percent of Commercial Spending:
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
5.9%
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
6.0%
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Calendar Year 2008
Salaries and Benefits
Other Expense
Total Indirect Health Care
Expense (by category)
Billing and Enrollment
1,555,150
2,661,286
4,216,436
Claim Processing
5,320,268
6,682,651
12,002,919
159,698
88,397
248,095
Customer Service
2,515,688
1,305,542
3,821,230
Product Management and Marketing
4,141,459
9,005,271
13,146,730
1,411,665
710,833
2,122,498
40,351
43,000
83,351
Provider Relations and Contracting
3,110,961
5,053,727
8,164,688
Quality Assurance and Utilization
Management
6,932,051
7,081,298
14,013,349
Wellness and Health Education
956,654
1,505,510
2,462,164
Research and Product Development
166,015
144,254
310,269
0
102,850
102,850
3,943,645
4,054,296
7,997,941
30,253,605
38,438,915
68,692,520
Detection and Prevention of Fraud
Underwriting
Regulatory Compliance and Government
Lobbying
Charitable Contributions
General Administration
Total Indirect Health Care Expenses
Taxes and Assessments
Calendar Year 2008
MinnesotaCare Tax
5,439,364
Other Taxes and Assessments
4,227,725
Capital Costs
Calendar Year 2008
2008 Incurred
2008 Payments
Capital Costs on Behalf of a Hospital or
Clinic
Capital Acquisitions
1,701,929
1,701,929
1,701,929
1,701,929
Other Capital Costs
Total Capital Expenditures
2008 Administrative Spending:
UniCare Life & Health Insurance Company
Total Administrative Spending as percent of Total Carrier Spending1:
11.2%
3.1%
Commercial Administrative Spending as percent of Commercial Spending:
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
Not Applicable
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
11.4%
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Billing and Enrollment
Calendar Year 2008
Salaries and Benefits
Total Indirect Health Care
Expense (by category)
Other Expense
657,080
791,774
1,448,854
1,799,809
1,514,206
3,314,015
9,487
9,938
19,425
675,015
802,801
1,477,816
3,081,804
4,919,311
8,001,115
Underwriting
312,175
131,007
443,182
Regulatory Compliance and Government
175,607
246,581
422,188
29,350
73,651
103,001
Provider Relations and Contracting
451,465
271,452
722,917
Quality Assurance and Utilization
Management
816,319
874,479
1,690,798
4,230
2,287
6,517
83,282
132,939
216,221
0
1,059
1,059
761,971
797,153
1,559,124
8,857,594
10,568,638
19,426,232
Claim Processing
Detection and Prevention of Fraud
Customer Service
Product Management and Marketing
Lobbying
Wellness and Health Education
Research and Product Development
Charitable Contributions
General Administration
Total Indirect Health Care Expenses
Taxes and Assessments
Calendar Year 2008
MinnesotaCare Tax
Other Taxes and Assessments
0
458,918
Capital Costs
Calendar Year 2008
2008 Incurred
2008 Payments
Capital Costs on Behalf of a Hospital or
Clinic
0
0
Capital Acquisitions
0
0
Other Capital Costs
0
0
Total Capital Expenditures
2008 Administrative Spending:
Union Security Insurance Company
Total Administrative Spending as percent of Total Carrier Spending1:
15.4%
Commercial Administrative Spending as percent of Commercial Spending:
15.4%
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
Not Applicable
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
Not Applicable
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Billing and Enrollment
Calendar Year 2008
Salaries and Benefits
Total Indirect Health Care
Expense (by category)
Other Expense
1,533
1,353
2,886
361,390
289,019
650,409
0
16,788
16,788
Customer Service
174,340
49,875
224,215
Product Management and Marketing
878,432
877,623
1,756,055
Underwriting
287,761
52,199
339,960
59,188
11,104
70,292
Lobbying
0
0
Provider Relations and Contracting
0
0
Quality Assurance and Utilization
Management
0
14
Wellness and Health Education
0
0
33,524
27,282
60,806
0
81
81
151,007
114,757
265,764
1,947,175
1,440,095
3,387,270
Claim Processing
Detection and Prevention of Fraud
Regulatory Compliance and Government
Research and Product Development
Charitable Contributions
General Administration
Total Indirect Health Care Expenses
Taxes and Assessments
Calendar Year 2008
MinnesotaCare Tax
Other Taxes and Assessments
0
497,428
Capital Costs
Calendar Year 2008
2008 Incurred
2008 Payments
Capital Costs on Behalf of a Hospital or
Clinic
0
0
Capital Acquisitions
0
0
Other Capital Costs
0
0
Total Capital Expenditures
14
2008 Administrative Spending:
United HealthCare Insurance Company
Total Administrative Spending as percent of Total Carrier Spending1:
6.1%
22.0%
Commercial Administrative Spending as percent of Commercial Spending:
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
Not Applicable
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
15.7%
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Calendar Year 2008
Salaries and Benefits
Total Indirect Health Care
Expense (by category)
Other Expense
Billing and Enrollment
2,052,664
2,052,664
Claim Processing
5,241,376
5,241,376
181,882
181,882
Customer Service
4,235,243
4,235,243
Product Management and Marketing
1,351,120
1,351,120
Underwriting
285,814
285,814
Regulatory Compliance and Government
103,932
103,932
Detection and Prevention of Fraud
Lobbying
0
Provider Relations and Contracting
3,377,801
3,377,801
Quality Assurance and Utilization
Management
4,676,955
4,676,955
Wellness and Health Education
0
Research and Product Development
Charitable Contributions
General Administration
Total Indirect Health Care Expenses
233,848
233,848
25,983
25,983
1,247,188
1,247,188
23,013,806
23,013,806
Taxes and Assessments
Calendar Year 2008
MinnesotaCare Tax
Other Taxes and Assessments
0
2,251,567
Capital Costs
Calendar Year 2008
2008 Incurred
2008 Payments
Capital Costs on Behalf of a Hospital or
Clinic
0
0
Capital Acquisitions
0
0
Other Capital Costs
0
0
Total Capital Expenditures
2008 Administrative Spending:
United World Life Insurance Company
Total Administrative Spending as percent of Total Carrier Spending1:
25.1%
Commercial Administrative Spending as percent of Commercial Spending:
Not Applicable
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
Not Applicable
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
25.1%
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Billing and Enrollment
Calendar Year 2008
Salaries and Benefits
Total Indirect Health Care
Expense (by category)
Other Expense
2,841
2,593
5,434
49,488
130,097
179,585
3,613
215
3,828
22,255
8,707
30,962
206,995
1,233,282
1,440,277
Underwriting
36,864
12,262
49,126
Regulatory Compliance and Government
17,108
15,691
32,799
3,826
1,440
5,266
49,539
11,185
60,724
392,529
1,415,472
1,808,001
Claim Processing
Detection and Prevention of Fraud
Customer Service
Product Management and Marketing
Lobbying
Provider Relations and Contracting
Quality Assurance and Utilization
Management
Wellness and Health Education
Research and Product Development
Charitable Contributions
General Administration
Total Indirect Health Care Expenses
Taxes and Assessments
Calendar Year 2008
MinnesotaCare Tax
155,496
Other Taxes and Assessments
174,544
Capital Costs
Calendar Year 2008
2008 Incurred
Capital Costs on Behalf of a Hospital or
Clinic
Capital Acquisitions
Other Capital Costs
Total Capital Expenditures
2008 Payments
2008 Administrative Spending:
WellCare Prescription Insurance, Inc.
Total Administrative Spending as percent of Total Carrier Spending1:
11.8%
Commercial Administrative Spending as percent of Commercial Spending:
Not Applicable
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
Not Applicable
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
11.8%
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Calendar Year 2008
Salaries and Benefits
Other Expense
Total Indirect Health Care
Expense (by category)
Billing and Enrollment
Claim Processing
Detection and Prevention of Fraud
Customer Service
Product Management and Marketing
Underwriting
Regulatory Compliance and Government
Lobbying
Provider Relations and Contracting
Quality Assurance and Utilization
Management
Wellness and Health Education
Research and Product Development
Charitable Contributions
General Administration
10,382
987,880
998,262
Total Indirect Health Care Expenses
10,382
987,880
998,262
Taxes and Assessments
Calendar Year 2008
MinnesotaCare Tax
Other Taxes and Assessments
Capital Costs
Calendar Year 2008
2008 Incurred
Capital Costs on Behalf of a Hospital or
Clinic
Capital Acquisitions
Other Capital Costs
Total Capital Expenditures
2008 Payments
2008 Administrative Spending:
World Insurance Company
Total Administrative Spending as percent of Total Carrier Spending1:
17.6%
Commercial Administrative Spending as percent of Commercial Spending:
16.9%
MN Public Programs Administrative Spending as percent of MN Public Programs
Spending:
Not Applicable
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare
Advantage, Part D, and Medicare Supplement):
22.1%
1
Self-insured expenses are not required to be reported, but are encouraged. When reported, these amounts are included in Total Administrative and Total
Carrier Spending; thus, the Total Administrative percentage may not fall within the range reported for the Commercial, MN Public Program, and Medicare
categories.
Indirect Health Care Expenses (Medical and Dental)
Indirect Expense Category
Calendar Year 2008
Salaries and Benefits
Total Indirect Health Care
Expense (by category)
Other Expense
Billing and Enrollment
241,564
161,916
403,480
Claim Processing
308,912
207,057
515,969
Customer Service
81,451
12,661
94,112
Product Management and Marketing
93,683
7,500
101,183
Underwriting
50,084
88,864
138,948
112,177
75,190
187,367
84
56
140
191,541
170,320
361,861
1,079,496
723,564
1,803,060
Detection and Prevention of Fraud
Regulatory Compliance and Government
Lobbying
Provider Relations and Contracting
Quality Assurance and Utilization
Management
Wellness and Health Education
Research and Product Development
Charitable Contributions
General Administration
Total Indirect Health Care Expenses
Taxes and Assessments
Calendar Year 2008
MinnesotaCare Tax
Other Taxes and Assessments
0
263,167
Capital Costs
Calendar Year 2008
2008 Incurred
Capital Costs on Behalf of a Hospital or
Clinic
Capital Acquisitions
Other Capital Costs
Total Capital Expenditures
2008 Payments
Appendix A: Definitions Definitions for the 2008 MDH Health Plan Financial & Statistical Report (HPFSR) Billing and Enrollment
Expenses
These are all costs associated with group and individual billing,
member enrollment and premium collection and reconciliation
functions. This may include costs for the collection and
reconciliation of cash, group and membership set-up and
maintenance, contract, identification card, and directory
preparation and issuance, electronic data interchange expenses
pertaining to billing and enrollment, and enrollment materials.
Traditional expense categories that your company might allocate
in whole or in part to billing and enrollment expenses include
finance and information systems.
Claim Processing Expenses
These are all costs associated with the adjudication and
adjustment of claims, coordination of benefits processing,
maintenance of the claim system, printing of claim forms, claim
audit function, electronic data interchange expenses pertaining to
claim processing, and fraud investigation. Traditional expense
categories that your company might allocate in whole or in part to
claims processing expenses include information systems and
legal.
Customer Service Expenses These are all costs associated with individual, group, or provider
support relating to membership, open enrollment, grievance
resolution, claim problems, and specialized phone services and
equipment. Traditional expense categories which your company
might allocate in whole or in part to customer service expenses
include information systems, finance, legal, and sales and
marketing.
Detection and Prevention
Of Fraud
These are all carrier costs relating to detection and prevention of
fraud.
Product Management and
Marketing Expenses
These are all costs associated with the management and marketing
of current products. This may include costs relating to product
promotion and advertising, sales, pricing, broker fees and
commissions, internal commissions and commissions processing,
marketing materials, account reporting, changes or additions to
current products, and enrollee education regarding coverage.
Traditional expense categories that your company might allocate
in whole or in part to product management and marketing
expenses include information systems, underwriting, legal,
finance, actuarial, public relations, and network management.
Underwriting
These are all carrier costs relating to underwriting.
Regulatory Compliance
and Government Relations
Expenses
These are all costs associated with federal and state reporting, rate
filing, state and federal audits, tax accounting, lobbying, licensing
and filing fees, and costs associated with the preparation and
filing of all financial, utilization, statistical, and quality reports,
and administration of government programs. Traditional expense
categories that your company might allocate in whole or in part to
regulatory compliance and government relations expenses include
information systems, finance, actuarial, sales and marketing,
underwriting, contract, legal, utilization management, quality
assurance, and compliance.
Lobbying
These are all carrier costs relating to lobbying.
Provider Relations and
Contracting Expenses
These are all costs associated with contract negotiation and
preparation, monitoring of provider compliance, field training
with providers, provider communication materials and bulletins,
and administration of provider capitations and settlements.
Traditional expense categories that your company might allocate
in whole or in part to provider relations and contracting expenses
include finance, legal, accounting, actuarial, and information
systems.
Quality Assurance and
Utilization Management
Expenses
These are all costs associated with quality assurance, practice
protocol development, utilization review, peer review,
credentialing, outcomes analysis related to existing products,
nurse triage and other medical care evaluation activities.
Traditional expense categories that your company might allocate
in whole or in part to quality assurance and utilization
management expenses include information systems and legal.
Wellness and Health
Education Expenses
These are all costs associated with wellness and health promotion,
disease prevention, member education and materials, provider
education, and outreach services. Traditional expense categories
that your company might allocate in whole or in part to wellness
and health education expenses include marketing, medical
services, and printing.
Research and Product
Development Expenses
These are all costs associated with outcomes research, medical
research programs, product design and development for products
and programs not currently offered, major systems development,
and integrated service network development. Traditional expense
categories that your company might allocate in whole or in part to
research and product development expenses include actuarial,
information systems, marketing, finance, underwriting, and
wellness programs.
Charitable Contributions
Expenses
These are all costs related to contributions made for charitable
purposes.
General Administration
Expenses
These are all costs not outlined or allocated to the other
categories. Traditional expense categories that your company
might allocate in whole or in part to general administration
expenses include human resources, facility maintenance, payroll,
general accounting, finance, executive, internal audit, treasury,
actuarial, finance, information systems, office management and
occupancy costs, general office supplies and equipment, legal,
board, outside consulting services, membership fees in trade
organizations, public relations, and mail room. Taxes and
assessments are not included in these costs.
Total Indirect Health Care
Expenses
This grand total should be equal to the sum across columns
(product categories) for the indirect expenses line in section 7.
MinnesotaCare Tax
Expenses
These are all payments paid to providers under Minnesota
Statutes, section 295.582 and payments made as a provider under
Minnesota Statutes, section 295.52, for the MinnesotaCare tax.
Other Taxes and
Assessments Expenses
These are all payments or amounts payable to government
agencies except for the MinnesotaCare tax under Minnesota
Statutes, section 295.52 and Minnesota Statutes, section 295.582.
This category does not include fees or fines paid to government
agencies.
Capital Costs on Behalf of
a Hospital or Clinic
These are all expenditures for capital that are incurred and/or paid
on behalf of a hospital or clinic (or part of a partnership, joint
venture, integration, or affiliation agreement). Report payments
made during the calendar year (including lease payments) along
with any costs incurred during the year.
Capital Acquisitions
These are all expenditures for the acquisition of capital assets.
Report payments made during the calendar year (including lease
payments) along with any costs incurred during the year.
Other Capital Costs
These are expenditures for other costs, such as legal or
administrative costs, that are directly associated with the incurring
of capital costs. Report payments made during the calendar year
(including lease payments) along with any costs incurred during
the year.
Total Capital Expenditures
This is the total of all the payments or incurred capital
expenditures listed.